About healthycaregiver

I took care of my husband for 10 years while he had earlier-onset Alzheimer's disease. My experience, along with my expertise as a wellness coach and health writer, prompted me to write a book on how caregivers can maintain their health, increase energy, and experience peace. My book "Calmer Waters: The Caregivers' Journey Through Alzheimer's and Dementia" will be released in June, 2016 by Cardinal Publishing Group. Please follow my blog for caregiving advice and the latest scientific studies on staving off dementia and supporting cognitive function.

10 ways to get siblings to help with the care of a parent

Family caregiver meeting

Today, June 20, is the longest day and for families in the throes of Alzheimer’s, it probably won’t seem any different than most days. Every day that you spend caring for a loved one whose needs are demanding is the “longest day.” In order to reduce the burden on yourself, it’s imperative that you carve out some “me time” each day. You’ve heard it before, but it is worth repeating: You need to take care of yourself, because if you get sick who will take care of your loved one?

Sharing the care

If you’re caring for a parent, have you had a conversation with your siblings about sharing the responsibility? Family dynamics and unresolved issues can make it harder to get everyone to pitch in. And of course, location makes a huge difference. An adult child who lives nearby the parent needing help, typically bears the brunt of the responsibility. In fact, a study done by the National Health and Aging Trends (2011-2017) found that three quarters of older adults reported receiving help from only one child.

In order to avoid resentment, divvy up the tasks.

Here’s how

  1. Have a family meeting. If there already is conflict and disagreement among siblings, find a professional to facilitate the meeting in a neutral place, such as a library meeting room, a church, mosque, temple, or synagogue, etc. If the parent being cared for wants to be included and is cognitively aware, include them.
  2. Introduce the purpose of the meeting and have an agenda. Begin with facts such a “Mom or Dad needs full-time care.” Or, “it’s time to move Mom or Dad to a memory care because she/he needs more care than I can provide.” Or, “Mom or Dad is still able to stay at home, but needs assistance. How can each of us help?”
  3. To clarify the situation, maybe include a doctor or nurse explain the medical issues and forecast what the future will look like.
  4. Next, discuss the care plan. Who can provide hands-on care at home? What kind of financial contribution can everyone provide? If the parent can remain at home, split up the day-to-day tasks such as grocery shopping, meal preparation, rides to the doctor, picking up medications, providing companionship, housecleaning, yard-care, etc.
  5. Acknowledge everyone’s feelings. Individuals will be at different places in their own lives. One sibling may be a new parent. Another may have lost their job. Or a sibling may live thousands of miles away. Or a sibling may be angry at a parent and not want to be involved at all. In these cases, ask gently if there is anything they can do to lighten the load for the others.
  6. If your parents have planned for retirement and were proactive about estate planning, your task will be easier than if they haven’t. Have them help you find the appropriate papers and resources as soon as possible while they are capable. Get the names and contact information for their legal professionals and make sure someone has been designated as power of attorney and durable medical power of attorney. If your parents have not done due diligence in sorting out their affairs and they are still able to, you need to stress the importance of doing so immediately. This is extremely important in the care of a parent. A sibling who is not involved in the hands-on care should be assigned this task.
  7. We’ve all become zoom experts in the past year and a half. Schedule monthly caregiver meetings so everyone stays informed about your parent’s needs. If a new care plan is needed, discuss the details.
  8. Make sure there is a point person for emergencies. Connect the family on “WhatsApp.”
  9. Take advantage of local resource such as Meals on Wheels and adult day programs.
  10. If siblings are unwilling to cooperate or if the situation escalates into an unmanageable situation, seek help. Call your local Area Agency on Aging. For more information, call the Family Caregiver Alliance, 800-445-8106 or visit http://www.caregiver.org and click on Family Care Navigator.

Express appreciation for any help your family is able to provide. Accept your siblings for who they are and understand that not everyone will agree with everyone’s opinion. Sharing the care for parents can either drive a wedge between siblings or bring them closer. Hopefully you’ll be able to communicate like adults and understand each other’s needs during the trying and stressful period that requires parenting our parents.

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

If you suspect that you or a loved one has Alzheimer’s, you need to read this.

June is Alzheimer’s and Brain Awareness Month. If you suspect that you or a loved one might have Alzheimer’s disease, here’s what you need to know.

After decades of not making progress with pharmaceuticals for Alzheimer’s disease, researchers are finally coming up with some promising results. There’s a brand new blood test for the disease that you can take instead of going through a series of expensive and sometimes painful tests. And there’s a brand new drug that delays cognitive decline in early stage Alzheimer’s. We still don’t have a cure, but there are a number of clinical trials that someone diagnosed with Alzheimer’s can enroll in.

Why it’s important to get diagnosed early

For a full explanation, click here to read a blog I posted August, 20202. https://barbracohn.com/blog/page/2/

Here are the bullet points:

  • Cognitive problems can be caused by a number of physical conditions.
  • Cognitive symptoms may be reversible.
  • An early diagnosis is empowering as far as estate planning, and end-of-life planning, etc.
  • An early diagnosis is easier for the physician to make when the patient is able to answer questions.
  • Family and loved ones might be confused by particular behaviors which will be explained.
  • An early diagnosis allows individuals to take advantage of support groups, and caregivers to learn ways to better manage medications, the environment, etc.
  • Getting an early diagnosis provides the opportunity to enroll in a clinical trial.
  • The patient can prioritize what is important to them while they are still able to make decisions.

What new tests are available to detect Alzheimer’s?

PrecivityAD is the first blood test for Alzheimer’s to be cleared for widespread use and one of a new generation of such assays that could enable early detection of the leading neurodegenerative disease—perhaps decades before the onset of the first symptoms. The test uses mass spectrometry to detect specific types of beta-amyloid, the protein fragment that is the culprit in Alzheimer’s disease. As plaques in the brain build up, levels of beta-amyloid decline in the surrounding fluid. The levels can be measured in spinal fluid samples. The new blood test can determine where beta-amyloid concentrations are significantly lower. PrecivityAd is designed to be used for people 60 to 91 years old with early signs of cognitive impairment.

How it works

  • Your doctor orders the PrecivityAd blood test and schedules a blood draw appointment.
  • Your blood sample is sent to the lab for analysis by mass spectrometry.
  • Your doctor receives the report and discusses the results with you.

How much does it cost?

The test costs $1,250. Since it is new and is not currently covered by private insurance, Medicare or Medicaid, patients must pay out-of-pocket for the test. A six-month interest-free payment plan is available, and a financial assistance program is available for patients who medically and financially qualify. The assistance program can bring the costs down to between $25 and $400 for eligible patients.

Other causes for memory issues

One benefit of the PrecivityADTM blood test is that if Alzheimer’s markers
are not detected, additional costly tests may be avoidable and your physician can explore other causes for memory and cognitive issues. Other causes for memory issues include: hypothyroidism, head trauma or injury, certain medications or a combination of medications, emotional disorders, depression, strokes, amnesia, alcoholism, vitamin B012 deficiency, hydrocephalus, brain tumors, and other brain diseases.

New drug for delaying symptoms

The FDA recently approved a new drug for Alzheimer’s. Aducanumab isn’t a cure, but it’s the first drug to get this far in an approval process that actually modifies the underlying pathology of the disease, and helps delay cognitive decline in early stage Alzheimer’s. Read about it in my last post. https://wordpress.com/post/barbracohn.com/6470

Clinical research studies for people with early symptomatic Alzheimer’s

The objective of a clinical research study is to answer questions about the safety and effectiveness of potential new medications. These studies have to be completed before a new treatment is offered to the public. There are currently more than 3000,000 clinical studies taking place throughout the world.

For those who are qualified, taking part in research studies offers several benefits:

  • Getting actively involved in their own health care
  • Having access to potentially new research treatments 
  • Having access to expert medical care for the condition being studied, since investigators are often specialists in the disease area being studied
  • Helping others by contributing to medical research

One way to find information about clinical trials is by searching this website: http://www.clinicaltrials.gov. ClinicalTrials.gov is an interactive online database, managed by the National Library of Medicine. It provides information about both federally and privately supported clinical research. ClinicalTrials.gov is updated regularly and offers information on each trial’s purpose, who is qualified to participate, locations, and phone numbers to call for more information.

The Alzheimer’s Association also has a service called TrialMatch that provides customized lists of clinical studies based on user-provider information. The free, easy-to-use platform allows you to see which studies are a good fit for you or a family member.
Visit TrialMatch
. You can also call 800.272.3900 or email TrialMatch@alz.org to get started. You’re under no obligation to participate. You can reach out to researchers directly to sign up, or let researchers know that you are open to being contacted with more information about their study. You can also browse available clinical studies by location and type, or sign up to be notified when new studies are posted that are relevant to you.



Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

New drug cites a 22% reduction in cognitive decline in early stage Alzheimer’s.

The FDA hasn’t approved a new drug for Alzheimer’s disease in more than 17 years. It looks like that is about to change. Aducanumab isn’t a cure by any means, but it’s the first drug to get this far in an approval process that actually modifies the underlying pathology of Alzheimer’s, and helps delay cognitive decline in early stage Alzheimer’s.

How does Aducanumab work?

Amyloid-beta is a protein that is normally present in the brain. In the Alzheimer’s brain the abnormal levels of the protein clump together to form amyloid plaques. Researchers think that these clumps lead to brain cell death.

Aducanumab is a monoclonal antibody that targets amyloid-beta.

Researchers developed it using Neurimmune’s proprietary Reverse Translational Medicine Platform. Neurimmune scientists discovered Aducanumab with a team of researchers at the University of Zurich. The human antibody targets the aggregated amyloid-beta. Through this interaction, Aducanumab could reduce the number of amyloid plaques present in the brain. This ultimately may slow neurodegeneration and disease progression.

Aducanumab in clinical trials

In 2007, Neurimmune licensed the exclusive rights to Biogen, which sponsored several clinical trials investigating Aducanumab in humans. Together, Neurimmune’s and Biogen’s scientists published a study in Nature 2016 that described how one year of monthly intravenous infusions of Aducanumab reduces brain beta amyloid in a dose- and time-dependent manner in patients with pre-dementia or mild Alzheimer’s disease. 1https://www.nature.com/articles/nature19323

The history of the clinical trials of Aducanumab is confusing. If you want to read the details about the trials continue reading. If you want the bottom line , scroll down and read from *But Biogen reversed course and decided to continue the trials.

On March 21, 2019, the manufacturer (Biogen) announced it had ended two Phase 3 clinical trials of Aducanumab for Alzheimer’s. The drug had failed a “futility analysis,” which means a clinical trial is stopped when the interim results suggest that it is unlikely to achieve statistical significance.1

But then just five months later, Biogen announced that they were applying for FDA marketing approval. They explained that data gathered in the three months between the start of the futility analysis and the decision to end the trial hadn’t been used in the original analysis. After adding the additional three months of data, they realized that a subset of patients who had been given higher doses saw significant benefits on measures of cognition and function, including memory, orientation and language. Those patients also saw benefits in daily living activities.2

The OptumRx Pipeline Surveillance team observed that despite the positive reported outcomes, Aducanumab has only demonstrated a statistically significant improvement in one of the two pivotal trials. Further, in the one positive trial, the reported improvements were small, and the true clinical relevance of the findings remain uncertain.

Researchers have completed three Phase 1 trials. These were assessing Aducanumab in healthy volunteers (NCT02782975) and in Alzheimer’s disease patients in the U.S. (NCT01397539) and Japan (NCT02434718).

A fourth, randomized, double-blind, and placebo-controlled Phase 1 trial (NCT01677572), PRIME, enrolled 192 pre-dementia and mild Alzheimer’s patients at 32 sites in the U.S. The goal was to assess the safety and effect of different aducanumab doses versus a placebo on amyloid plaques. Researchers measured this with positron emission tomography imaging.

Interim results from the first 165 patients showed that all doses of Aducanumab (given as monthly infusions into the bloodstream) significantly reduced amyloid plaques in the brain in a time- and dose-dependent manner. During the first year, 40 patients from both groups discontinued treatment. Little to no change was apparent in the placebo group after one year. The greatest reduction was present at higher doses. Aducanumab also appeared to slow the rate of cognitive decline. Researchers measured this as a change in the clinical dementia rating sum of boxes (CDR-SB) and the mini-mental state examination (MMSE).

They presented results from a long-term extension of the PRIME trial at the 2017 Clinical Trials on Alzheimer’s Disease meeting. In total, 143 patients from the initial trial opted to continue in the long-term extension study, where all patients received Aducanumab. This included data from patients who had been on Aducanumab for up to three years. During this time, patients who received Aducanumab continued to experience a time- and dose-dependent reduction in amyloid plaque levels.

Biogen also began two large-scale randomized, double-blind, and placebo-controlled Phase 3 clinical trials in people with early-stage Alzheimer’s disease. The first trial, called ENGAGE (NCT02477800), aimed to enroll 1,350 patients at 187 sites in North America, Australia, Europe, and Asia. The second trial, called EMERGE (NCT02484547), also sought to enroll the same number of patients at 194 sites in North America, Europe, and Asia.

The goal of both trials was to assess the efficacy of Aducanumab, given once a month at low and high doses by infusion into the bloodstream. Researchers measured the effectiveness of the treatment by changes from the start of the study in the CDR-SB, MMSE, Alzheimer’s disease assessment scale-cognitive subscale 13 items (ADAS-Cog 13), and Alzheimer’s disease cooperative study-activities of daily living inventory mild cognitive impairment version (ADCS-ADL-MCI) scores over a 78-week period. They had expected to complete the trials in 2022.

The company halted the trials because an independent data monitoring committee found that they were unlikely to meet their primary objective. This was based on initial data from the trials and not on safety concerns. Follow-up visits and closing-out activities for both trials are now complete.

The Phase 2 EVOLVE trial (NCT03639987) began in late 2018 to evaluate the safety of continued dosing of Aducanumab in participants with mild cognitive impairment due to Alzheimer’s disease or with mild Alzheimer’s disease dementia. This trial also was halted in March 2019 as a result of the committee’s findings.

*But Biogen reversed course and decided to continue the trials.

later analysis based on additional follow-up data, showed that EMERGE met its primary goal. Patients receiving the highest dose of Aducanumab experienced a significant reduction in the progression of cognitive and functional impairments. Although ENGAGE failed to meet its primary goal, Biogen stated that data from the sub-group of patients who had sufficient exposure to the medication also showed significant benefits. These and other supportive findings formed the basis of the company’s BLA (Biologics License Application) submitted to the FDA requesting the approval of Aducanumab for the treatment of Alzheimer’s disease.

In August 2020, Aducanumab was granted priority review by the FDA, meaning that the agency plans to expedite the review process to determine whether they will approve the medication. 

Are there any negative side effects from taking Aducanumab?

Researchers said a majority of the test subjects taking Aducanumab showed no negative side effects. In some cases, however, patients experienced swelling in the brain called “amyloid-related imaging abnormalities” (ARIA) and headache.

How is the drug administered?

Intravenous doses of Aducanumab are given about 4 weeks apart over approximately 52 weeks for a total of 14 doses. Qualifying patients can continue into the long-term extension at a dose approximately 4 weeks apart for up to an additional 112 doses.

When will Aducanumab become available?
The FDA process for reviewing applications for approval, called New Drug Applications or NDAs, usually takes around 10 months. Biogen has said the Aducanumab application has about 4,500 files with more than 2.5 million pages of data and information. Biogen believes a decision will be made by June 7, 2021. Though the FDA would continue to monitor the effects of the drug, to ensure no unexpected side effects from prolonged usage, after approval the drug can be made available widely. People with Alzheimer’s disease may have a new medication to take soon.

How much will it cost?

Aducanumab is expensive, with the annual cost projected to be around $50,000 for the recommended dosage, based on one infusion per month. Even if the drug is approved by the FDA, the Centers for Medicaid and Medicare Services can determine for themselves how much Medicaid and Medicare will cover Aducanumab if the cost is high. PET brain scans to detect amyloid beta plaques would probably be necessary to determine aducanumab coverage, and those are expensive as well.

Where can I buy it?

I ordered Memantine for my husband from Europe before it was available in the U.S. India manufacturers provide many of the drugs sold in the U.S. I found this website for an Indian Pharmaceutical company which sells Aducanumab throughout the world. https://indianpharmanetwork.co.in/buy-aducanumab.php

The problem, of course, with buying Aducanumab from an Indian pharmacy is that you’d have to find a doctor who is willing to administer it intravenously. Since it is expected to be approved this summer, it’s probably more prudent to wait until you can get it prescribed by your doctor. But keep in mind that you might be able to save money by ordering it from India even after it is approved by the FDA.

Although Aducanumab isn’t a cure for Alzheimer’s, it is the first drug that is showing some promise for providing more time to individuals with this insidious disease.

References

  1. The Lancet. A resurrection of aducanumab for Alzheimer’s disease. Published December 4, 2019. Accessed January 7, 2020.
  2. Bio Space. Biogen Alzheimer’s Plans Met with Hope, Some Skepticism. Published: December 6, 2019. Accessed January 7, 2020.

20 Ways to prevent falls in Alzheimer’s patients

Woman falls on slippery bathroom floor.

People with Alzheimer’s and other types of dementia are four to five times more likely to fall than older people who don’t have cognitive impairment. They are also three times more likely to fracture their hip when they fall, which leads to surgery and immobility. The rate of death following a hip fracture for those with Alzheimer’s is also increased.

A person with dementia may have trouble recognizing sight, sound or touch. Their vision may be distorted, not because of an actual eye problem but because of how the brain interprets what it is seeing. They may have problems with depth perception, get confused by patterns or light intensity, and they may lose coordination of movement and physical strength.

Some of these changes are inevitable and irreversible. However, movement and physical activity can go a long way toward fall prevention.

Scott Salus, occupational therapist and co-owner with physical therapist Daniel Basta, of Kind Rehabilitation says, “One of the main things that helps prevent falls is understanding that a fear of falling is one of the best predictors that someone will eventually fall.

“It’s really important to address falls before they happen. Caregivers need to come from an honest and firm place, because the moment someone has their first fall that can be the moment they lose their independence,” he says.

When Salus’ then-65-year-old, physically-fit mother and her boyfriend were moving, he insisted they look into the future to think about mobility issues. Would it be more prudent to live in a ranch than a multi-level home? “You can start the conversation early and plan for an eventuality that may never take place,” he says.

Salus, who specializes in working with patients with dementia and Parkinson’s, says, “The process of fall reduction is a delicate one that includes practicing every-day activities. We

reassure patients that it’s safe to practice pulling up their pants, or going into a shower fully clothed.”

He evaluates if the patient has vertigo when bending to tie their shoes or getting up from a seated position. Have they had a recent surgery or new diagnosis? How do they manage pain? Do they need a commode, or learn to reposition their arms, feet, and legs when toileting or getting out of a chair?

A physical therapy program might include exercises for strength, flexibility, good posture, and gait training. Learning to maintain balance while you’re walking and distracted or multi-tasking is also important, Salus adds.

The Feldenkrais Method® (Awareness Through Movement® and Functional Integration® developed by Moshe Feldenkrais) is another modality that helps prevent falls by teaching individuals to pay closer attention to the way they move.

Al Wadleigh, a Feldenkrais practitioner who teaches privately and at the Longmont Senior Center, starts a chair class by asking the participants to begin with a scan by turning the awareness inward. “Get a sense of how you’re making contact with the chair and with your feet on the floor. How is your weight distributed on the pelvis? Now roll back and forward to sense how your lower back is in relationship to the chair,” he says.

“We go through the lessons—and there are 2,000 of them—to fill out the idea of exploring and sensing what feels good. It’s to figure out, when given a better opportunity and choice, what the nervous system prefers. It’s development learning in order to change habits from old injuries, surgeries, emotions, work, and thoughts that don’t serve us.”

The aim of Feldenkrais is to invigorate your brain and nervous system with new ways of organizing and sensing your movement in the world. “Around age 50 the brain says ‘we’re not using all our neuro-pathways.’ We have fewer to rely on, so we have to neutralize the old habits in order to live life with more vitality,” Wadleigh adds.

He ends the class by asking participants to do a self-inquiry. One person says, “I’ve done the pelvis rock many times but sitting on a chair made it clearer.”

Wadleigh responds that the smaller the movement the more precise it can be. Once you’re aware of what you’re not aware of, you can fill in those parts.”

Another person with Multiple Sclerosis says that one of his feet was dragging that morning. “Now I can lift it up.” He adds, “I feel a centered-ness since doing Feldenkrais, and have better structure. Now when I stand and I’m reaching for something I’m able to move easier. That’s big for me.”

20 Tips for preventing falls

  1. Have adequate lighting throughout the house; place night lights in the bedroom and bathroom.
  2. Limit liquids after dinner to reduce night-time toileting.
  3. Get adequate sleep.
  4. Remove loose area rugs.
  5. Wear gripping socks, sturdy slippers, or shoes in the house.
  6. Avoid unsafe shoes, i.e. flip flops and high-heels.
  7. Place guardrails where needed.
  8. Stand up slowly.
  9. Use a walker or cane for steadiness.
  10. Declutter and remove excess furniture.
  11. Implement an exercise program to support muscle strength, stability, and balance.
  12. Use a “reach stick” to grab out-of-reach items.
  13. Do not use a step ladder.
  14. Eliminate or reduce alcohol and smoking.
  15. Be wary of medications that cause dizziness, sleepiness, and unsteadiness.
  16. Be attentive to pain management.
  17. Be aware of where your pet is to avoid tripping.
  18. Get adequate calcium and vitamin D to maintain bone health.
  19. Maintain a healthy weight.
  20. Get regular vision and hearing check-ups.
Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Pets can provide people with Alzheimer’s and dementia companionship, comfort and joy

Man resting in garden with his dog

My next door neighbor got an adorable lap dog that loved him to pieces during his struggle with Alzheimer’s. Now that he has passed away, his wife has a loving companion that gets her outside several times a day for walks. And that animal gazes at her with the love that only a dog can give. This was a success story of dog companionship for an elderly couple immersed in navigating the dark Alzheimer’s journey.

Pets can provide loving companionship, emotional therapy, and an excuse for getting out of the house for a walk and chat with other people on the trail. But pets can also pose a hazard when they get in our way or pull hard on a leash.

I have a friend who tripped this winter while walking her dogs. She fell and broke her collarbone. Another friend tripped over her dog in the kitchen and instinctively put her hand out to brace a fall. Unfortunately, she put her hand on a very hot stovetop and got a second-degree burn.

Pets offer numerous benefits

When people interact with pets the physiological response is a lowering of blood pressure and an increase in the neurochemicals associated with relaxation and bonding. These effects can help ameliorate behavioral and psychological symptoms of dementia. Several small studies suggest that the presence of a dog reduces aggression and agitation, and promotes social behavior in people with dementia. One study showed that having aquariums in the dining rooms of memory care homes stimulates residents to eat more and to maintain a healthier weight.1

When a dog is brought to visit memory impaired individuals (either at home or a facility), unexpected and positive reactions occur. Some patients who have refused to speak will talk to the dog, and others who have refused to move might pet the dog.

My daughter often brought her Miniature Schnauzer, Paco, to the memory care home where my husband lived. Paco always brightened the day for Morris and the other residents. He would run around scrounging for crumbs and sniffing the residents’ feet. Some residents reached out to touch him. One lady liked to hold him like a baby. She’d place a napkin on his head, pretending it was a hat. Paco created a bit of a stir, but he brought a smile to everyone’s face, including mine.

The human-animal bond goes beyond the mind and is centered in the heart. It can nurture us in ways that nothing else can. Sometimes a person with memory loss won’t be able to recognize a spouse, but can recognize a beloved pet. Just three days before Morris died a friend visited him with his trained pet therapy dog. Morris was bedridden, dehydrated, and non-communicative, but he opened his eyes and reached out for the dog.

If your loved one is used to being around animals, has had a pet, or if there is an animal that he or she is familiar with, by all means encourage the interaction to continue. It’s an easy, wonderful way to promote ease and happiness among care partners.

If you’re considering getting an animal companion, consider the following pros and cons.

10 Ways an animal companion or pet can help a person with dementia

Pets can:

  • Offer people with dementia unconditional love
  • Help relieve stress and anxiety
  • Help build confidence
  • Encourage laughter
  • Improve self-esteem
  • Help the person reminisce and recall memories
  • Provide an opportunity to get outside and walk
  • Support social activities, i.e. talking about the animal with neighbors, grandchildren, etc.
  • Bring back a sense of fun
  • Provide an opportunity to care for a living being, which in turn promotes empathy.

Things to consider

  • Does the person have the mental capacity to take care of the animals’ needs?
  • If the person has a caregiver, is that caregiver willing to provide the care for animal, including visits to the veterinarian.
  • Not everyone wants to interact with animal. Make sure the person really wants a pet and/or visit from a therapy dog.
  • A stuffed animal, cuddly toy, or robotic toy animal might provide the comfort that the person would get from having a pet. This might be a good option to explore before making a commitment to getting animal.
  • What happens if the person dies? Consider who will take responsibility for the animal.

In the end, you may find that a lower maintenance animal is a better fit. A fish aquarium can provide gentle stimulation, and quiet, relaxing beauty and grace.

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Dental hygiene for people with dementia

oral hygiene products

As with any debilitating disease, Alzheimer’s and other dementias pose limitations to what a patient can and can’t do. Good dental hygiene is one of the self-care daily habits that, unfortunately, often fall by the wayside in cognitively impaired individuals.

In the beginning stages of Alzheimer’s, a daily reminder might be all it takes to ensure that a person with dementia continues with their dental hygiene routine. As the disease progresses, the individual might need a more hands-on approach.

Why is dental care for dementia patients important?

It doesn’t matter whether you have dementia or are in tip top shape, dental care is a primary factor in overall health. Maintaining your dental health is much more than having a beautiful smile. Tooth decay and gum disease can affect your heart, your lungs, and your brain.

Periodontal disease has been linked to diabetes, heart disease, and Alzheimer’s disease.

According to the U.S. Centers for Disease Control and Prevention, one out of every two American adults over the age of 30 has some form of gum disease. Oral bacteria can migrate to distant sites in the body. Elderly and immuno-compromised patients, such as those suffering from cancer, diabetes or rheumatoid arthritis, may be especially vulnerable to systemic oral pathogens.

Periodontal disease is also associated with weight loss and wasting, which might contribute to cognitive decline. Gum disease often results in tooth loss, which often leads to problems with chewing, swallowing and food selection. And individuals don’t absorb nutrients from food efficiently if it is not chewed well. Evidence from several studies indicates deterioration in nutritional status in individuals missing teeth.

Certain medications can cause dry mouth

Decongestants, antihistamines, painkillers, diuretics and antidepressants are known to reduce saliva flow. Saliva neutralizes acids produced by bacteria in the mouth and helps protect you from microbes that can multiply and lead to infection and disease. The problem is, salivary glands are less productive as we age. Individuals with dementia also forget to drink when they’re thirsty. It’s important to be alert to cracked lips and dry mouth in your care partner in order to know when an individual is dehydrated.

8 Tips for preventing dry mouth

  • Sip water throughout the day—carry a water bottle.
  • Suck on hard, sour candies.
  • Chew sugarless gum.
  • Avoid or reducing the medications listed above.
  • Use Biotene, Plax, or ACT mouthwash which contain no alcohol.
  • Eat fibrous foods like apples, carrots and celery. They’re mildly abrasive and sweep bacteria and plaque off the teeth.
  • Use a humidifier to keep the membranes moist.
  • Get regular dental check-ups and alert the dentist about dry mouth. The teeth can sometimes be coated with protective substances that protect the teeth from bacteria and plaque.

12 Ways to assist dementia patients with oral hygiene

  • Talk your patient through the steps of brushing, if necessary. Put your hand over their hand that is holding the brush to guide them.
  • We typically brush our teeth in the bathroom. However, if it’s more comfortable for someone to brush while sitting down on a chair or in bed, by all means provide a plastic tub and glass of water for the patient.
  • As dementia progresses, it becomes more difficult for patients to visit their dentist for regular cleanings. It also becomes more difficult for caregivers to help with daily brushing, which is why caregivers must be more diligent in trying other techniques.
  • If a regular toothbrush is hard to hold and manipulate, try an electric toothbrush. Or, provide a toothbrush with a large handle. Some caregivers get creative and put the handle through a tennis ball to give the patient something heftier to hold onto.
  • Don’t use fluoride toothpaste if the patient is inclined to swallow it. If the patient doesn’t like toothpaste, try using baking soda and water, or just plain water.
  • Flossing is very important. See “Does gum disease really cause Alzheimer’s disease?” https://barbracohn.com/?s=flossing&submit=Search. Flexi-Floss, Stim-u-dent-or a tiny brush makes the job a bit easier.
  • If you can trust the patient not to swallow mouthwash, try an anti-plaque mouthwash when brushing is not feasible.
  • Ask your dentist about using a super soft toothbrush or one with a sponge head instead of a bristle head. Foam oral swabs are available at medical supply companies.
  • If your patient wears dentures, make sure to take them out and clean them daily. Use a soft brush to clean the patient’s gums and roof of their mouth when the dentures are removed.
  • Be alert to dental pain which may be exhibited by rubbing of the jaw or cheek, flinching while being shaved or having their face washed, refusing to put dentures back in, moaning, flinching, etc.
  • As mentioned in the above section, eating fibrous foods like apples and celery, and drinking plenty of water can help prevent plaque build-up.
  • It’s important to find a dentist who is patient and knowledgeable about dementia in order to make your patient’s dental visits as pleasant as possible. Let the staff know ahead of time about any concerns. If your patient gets agitated, ask his/her physician for an anti-anxiety medication beforehand. Or, use a homeopathic remedy such as calcarea carbonica or aconite, or an essential oil such as lavender oil to reduce anxiety. For a list of herbal remedies that reduce anxiety see “20 Natural Remedies for Depressed Caregivers (and everyone else).” https://barbracohn.com/category/aromatherapy/

References

  1. Hee Lee, K, Wu, B, and Plassman, B. Cognitive function and oral health—related quality of life in older adults. JAGS. 2013: 61: 1602-1607.

2. Elsig, F, Schimmel, M, Duvernay, E, Giannelli, SV, Graf, CE, Carlier, S, Herrmann, FR, Michel, JP, Gold, G, Zekry, D and Muller, F. Tooth loss, chewing efficiency and cognitive impairment in geriatric patients. Gerodontology. 2013: 1-8.

3. Chalmers, JM, Carter, KD, and Spencer, AJ. Oral diseases and conditions in community-living older adults with and without dementia. Spec Care Dentist. 2003: 23: 7-17.

4. Fabiano, JA. Oral health management in the patient with dementia. Medscape. May 24, 2011.

The truth about eating chocolate

Dark chocolate stack, chips and powder

Americans eat more than 11 pounds of chocolate each year, which is far less than most Europeans, especially the Swiss, who eat 19 pounds a year.

There’s a big difference between eating dark chocolate and milk chocolate. Dark chocolate has the highest percentage of cocoa solids and cocoa butter, as well as sugar and cocoa bean powder. It also contains flavonoids, plant-based compounds that have anti-inflammatory and antioxidant properties the support immunity. Additionally, it contains magnesium, sulfur, calcium, iron, zinc, copper, potassium and manganese, which are essential minerals. Dark chocolate also contains epicatechin and Gallic acids which support the heart, act as an anticarcinogens (anti-cancer), and support brain health and mental clarity.

Milk chocolate contains milk powder, sugar, and a small percentage of cocoa solids and cocoa butter. It has a creamier and sweeter taste. It contains less than 10 percent of cocoa versus the minimum of 35 percent cocoa that dark chocolate contains, which means it doesn’t offer nearly the number of health benefits as dark chocolate.

Nutritionists recommend consuming chocolate products that contain 70% to 80% cocoa. If you just want the pure and simple health benefits, forego the chocolate and take raw cacao capsules. Although I definitely wouldn’t recommend giving your sweetheart a bottle of cacao capsules on Valentine’s Day. Indulge in the good-tasting stuff!

Interesting health facts about chocolate

  1. Chocolate is an aphrodisiac. Legend has it that the Aztec emperor Montezuma was said to consume large amounts of the cocoa bean to fuel his libido. Today, scientists attribute the aphrodisiac qualities of chocolate to two chemicals: 1) tryptophan, which is a building block of serotonin, a brain chemical involved in sexual arousal. And, 2) phenylethylamine, a stimulant related to amphetamine, that is released in the brain when people fall in love. What about you? Do you experience a heightened sense of arousal after eating dark chocolate?
  2. Chocolate contains good-for-you antioxidants Chocolate comes from the cacao bean, which thrives in hot, rainy climates in South America, Africa and Indonesia. Similar to grapes, the local soil and climate affects the taste of the harvested beans. When you buy a chocolate bar that has the percentage number on the bar wrapper, that represents the weight that comes from the cacao bean content, according to Robert L. Wolke, author of What Einstein Told His Cook: Kitchen Science Explained. The higher the number, the lower the percentage of sugar and the more bitter and complex the flavor, he says. And the higher the number the more antioxidants.
  3. Cacao is rich in magnesium, sulfur, calcium, iron, zinc, copper, potassium and manganese, all essential minerals . . . and antioxidants that support immune health.
  4. Chocolate reduces your risk of Type 2 Diabetes Researchers discovered that the flavanols in chocolate have beneficial effects on insulin resistance, a risk factor for Type 2 diabetes. In a 30-year-long study of 953 men and women from the Maine-Syracuse Longitudinal Study (MSLS), researchers found that the individuals who never or rarely ate chocolate had a significantly higher chance of developing Type 2 diabetes after five years when compared to individuals who ate chocolate more than once a week. Habitual chocolate intake and type 2 diabetes mellitus in the Maine-Syracuse Longitudinal Study: (1975-2010): Prospective observations.
  5. Protects you from heart disease A 2012 report published in the American Journal of Clinical Nutrition found that dark chocolate has a beneficial effect on blood pressure, vascular dilation and cholesterol levels, and can play a role in reducing metabolic precursors that lead to diabetes and eventually to heart disease. However, a study published in October 2016 (John Wiley & Sons, Ltd.) found that out of 32 cocoa product samples analyzed, the cocoa flavanol dose must be about 900 mg or above to decrease blood pressure, and contain 100 mg of epicatechin. So if you want to eat chocolate for health benefits, be sure to check the ingredient label. The aim of the study was to review the effect of cocoa flavanols on cardiovascular health, with emphasis on the doses ingested, and to analyze a range of cocoa products for content of these compounds. PubMed was searched from 2010 to locate systematic reviews (SR) on clinical effects of chocolate consumption.
  6. Supports mental function. A recent analysis of several studies on the effects of cocoa polyphenols on cognition in healthy adults found that they enhanced memory and executive function. https://pubmed.ncbi.nlm.nih.gov/31933112/ In an earlier study carried out by the University of L’Aquila in Italy, 90 elderly participants with mild cognitive impairment (MCI) drank cocoa containing high, medium or low levels of flavonoids. At the end of the eight-week study researchers found improvements in the motor response, working memory, task switching, and verbal memory in the participants who drank cocoa with a higher flavanol content. (Hypertension, Aug. 14, 2012) Alzheimer’s and dementia patients are especially fond of sweets because the taste of sweetness is the last taste to disappear. Another study which evaluated the effect of cocoa flavonoids on cognitive function, blood pressure control and metabolic function in the elderly also found positive results. https://pubmed.ncbi.nlm.nih.gov/25733639/ So if your loved one has Alzheimer’s or dementia, indulge him/her in chocolate. Just remember not to overdo it and make sure to include good dental hygiene in your loved one’s daily regimen.
  7. Helps you think better after a sleepless night. The next time you have a bad night’s sleep, instead of indulging in a cup of Joe drink hot chocolate. Sleep deprivation is a risk factor for cardiovascular disease, and scientists have found that flavanol-rich chocolate counteracted vascular impairment after sleep deprivation and restored working memory performance. Their theory is that the study’s participants had improved cognitive performance because of the effects of cocoa flavonoids on blood pressure and blood flow.Flavanol-rich chocolate acutely improves arterial function and working memory performance counteracting the effects of sleep deprivation in healthy individuals.
  8. Makes you feel gooood Scientists have discovered why chocolate uplifts your mood. Serotonin is the neurotransmitter responsible for keeping us happy, and cacao stops the amino acid tryptophan from breaking down. Since tryptophan is one of the amino acids that make serotonin this, in turn, limits the breakdown of serotonin. https://pubmed.ncbi.nlm.nih.gov/25733639/

On Valentine’s Day celebrate with your loved one by enjoy a steaming cup of delicious hot chocolate made with whole milk or rice or flax milk. Or indulge in a dark chocolate truffle, candy bar or chocolate ice cream. It’ll boost your spirit and your immunity. Just be careful not to overdo it because the calories can add up quickly.

This is what I’m making on Valentine’s Day. Substitute coconut sugar or raw sugar, if you like.  This recipe is easier than you’d think, so don’t let the word souffle scare you off. It’s well worth the time and little effort it takes.

Chocolate Souffle

Ingredients

  • 1⁄3 cup sugar, plus additional for sprinkling
  • 5 ounces bittersweet chocolate chips
  • 3 large egg yolks, at room temperature
  • 6 large egg whites
  • 1⁄8 tablespoon butter

Directions

  • Preheat oven to 375°F.
  • Measure out sugar, chocolate and separate eggs.
  • Butter soufflé dish entirely and then add sugar (additional) coating the entire dish.
  • Melt chocolate in a double boiler, or directly on the stove.
  • Add yolks to chocolate (this will harden the chocolate so don’t be alarmed).
  • Beat egg whites with a pinch of salt. Slowly add sugar, a little at a time. Beat until egg whites hold stiff peaks.
  • Fold white mixture into chocolate slowly and stir until smooth.
  • Pour into large soufflé dish or 4 ramekins and run the end of your thumb around inside to remove any extra batter.
  • Bake until puffed and crusted on top but still jiggly in center, 20 to 25 minutes.
  • Serve immediately with whipped cream or ice cream.

This recipe has become one of my new favorites.

Chocolate zucchini bread

Ingredients

  • 2 cups grated zucchini
  • 2 eggs
  • 1/2 cup unsweetened applesauce
  • 1/2 cup maple syrup (add 3/4 cup if you like it sweet, I don’t)
  • 1 tsp baking soda
  • 1 tsp baking powder
  • 1/2 tsp salt
  • 1/3 cup unsweetened cocoa or cacao powder
  • 2 cups flour of your choice. I use 1 cup almond meal and 1 cup whole wheat
  • 1/2 cup semi-sweet chocolate chips

Directions

  • Preheat oven to 350 degrees. Spray loaf pan with oil or rub with butter.
  • In a large bowl mix egg, applesauce, maple syrup, baking soda and baking powder and salt.
  • Add cocoa powder and whisk until well combined.
  • Add flour and mix until combined. Add 1/4 cup of chocolate chips.
  • Pour batter into pan and sprinkle remaining chips on top.
  • Bake 40-50 minutes or until inserted toothpick comes out clean. Be careful not to hit a melted chocolate chip.
  • Let cool before slicing.

Yay chocolate! Have a very happy Valentine’s Day!

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

What if the Alzheimer’s patient gets cancer?

As if it weren’t bad enough to endure Alzheimer’s disease, when the patient gets a cancer diagnosis things go from bad to worse for the patient and the caregiver. Here’s what’s really interesting though. Studies show that individuals with Alzheimer’s have a lower risk of cancer and that cancer patients have a lower risk of Alzheimer’s.

In the Framingham Heart Study (FHS) Offspring cohort from 1999-2005, 2,043 participants (54% of them women) without dementia were given neuropsychological tests of memory and executive functioning, in addition to brain MRIs. The cohort consisted mainly of highly-educated, white, healthy middle-aged adults.

There were 252 participants with a previous history of cancer, and 1,7791 without a previous history of cancer. Those with invasive cancers, including the largest sub-types of prostate and breast cancer, actually had better executive function, but not memory function, and larger frontal brain volumes when compared to their peers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659723/

In a previous prospective analysis including 1,274 members of the original FHS cohort, cancer survivors were found to have a 33% decreased risk of developing probable Alzheimer’s disease. https://pubmed.ncbi.nlm.nih.gov/22411920/

So, should you breathe a sigh of relief? It’s unclear because the researchers lacked information on the type of cancer treatments the patients received. They didn’t take into consideration whether the patients were getting chemo or hormonal therapy. They also concluded that they had insufficient evidence because the group of individuals were mainly white, well-educated and healthy middle-aged adults. But it does offer hope that if you have or had cancer, your chances of getting AD is and vice versa is less.

What if you’re caring for someone with Alzheimer’s disease who gets diagnosed with cancer?

There are two important questions to ponder in this situation.

  1. What stage Alzheimer’s is the patient in?
  2. What stage and type is the cancer?

Many factors come into play here: age of the patient, the stage of Alzheimer’s, and the cancer prognosis. It’s a tough one. If the person is in the earlier stages of Alzheimer’s, they might be able to understand the treatment and be willing to go through it. If you are their caregiver, be prepared to go to all doctor appointments with them. Take notes, have the doctor make eye contact with the patient and explain and repeat things in simple language, if necessary. Provide the information in a quiet space without distractions. If your loved one is admitted to the hospital, provide the staff with information about their cognitive needs.

If your loved one has advanced Alzheimer’s you’d have to consider whether putting the patient through cancer treatment is something that the patient would want to do. They will be confused, possibly terrified, and suffer greatly from side effects. Also, a person with late-stage Alzheimer’s doesn’t have a lot of quality of life. Is it worth it?

If the cancer is widespread it could result in pain and discomfort for the patient. Or it might be a slow-growing cancer such as prostate, that can be treated without invasive surgeries or treatments.

It can be difficult to know what is best for the patient. If you are faced with a situation such as this, or another difficult diagnosis, get help from a professional social worker or therapist. Have a family conference, but know there might be conflicts that arise when not everyone is on board.

And remember, you are doing the best that you can do. Take care of yourself and remember to breathe. “This too shall pass.”

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Is there a link between radon exposure and Alzheimer’s disease?

January is National Radon Action Month and if you haven’t tested for radon in your home in the past year, this is a good reminder to put it on your to-do list. Radon is a naturally occurring, invisible, odorless gas that decays into radioactive particles. Radon exposure is the second leading cause of lung cancer after smoking. It’s estimated that about 20,000 lung cancer deaths each year are caused by radon exposure. I’m just learning that It is also linked to neurodegenerative diseases.

My husband spent many hours each day in his basement office. When we put our house up for sale, we had to do a radon mitigation after discovering that we had high radon levels. Now I’m wondering if his Alzheimer’s disease was caused by the radon. In a systematic review of the topic, ten studies have been related to multiple sclerosis (MS), two related to motor neuron disease, in particular ALS, and three were related to both Alzheimer’s disease and Parkinson’s disease. https://pubmed.ncbi.nlm.nih.gov/33066046/

I’ve also just learned that the average radon level in a home in Colorado, where I live, is equivalent to every person in the home having 200 chest X-rays a year. That’s scary!

The Journal of Alzheimer’s Disease published an article concluding that ionizing radiation is a risk factor for Alzheimer’s. Inhaling radon gas, can damage tissue in the nasal cavity and hippocampus that, overtime, results in Alzheimer’s.

The researchers did an extensive study of ionizing radiation exposure of the population in the U.S. and compared that with 2013 death rates by states provided by the Alzheimer’s Association. They found that radon background ionizing radiation was significantly correlated with AD death rate in 50 states and the District of Columbia.

Signs and symptoms of radon exposure and possible lung cancer from radon

  • Persistent cough
  • Hoarseness
  • Wheezing
  • Shortness of breath
  • Coughing up blood
  • Chest pain
  • Frequent infections like bronchitis and pneumonia
  • Loss of appetite
  • Weight loss
  • Fatigue

What can you do?

Testing for radon is easy and inexpensive. Kansas State University National Radon Program Services offers low-cost test kits online. To order a test kit from KSU, go to sosradon.org. Kits can also be found at local hardware and home improvement stores.

If you find radon in your home, A properly installed radon mitigation system will harmlessly disperse the radon gas, making your home dramatically safer. The best part is that these mitigation systems are affordable to install and require minimal maintenance over their lifespan.

I’m ordering a radon testing kit ASAP. This is something that’s easy to do and can help prevent serious diseases. Please get one for your home, too.

Take care and stay safe.

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

14 ways that caregivers can achieve a healthier, more relaxed 2021

You’re tired, you’re stressed – You and 45 million or so American caregivers, including the 16 million adult family members caring for a someone with Alzheimer’s. So what are you going to do about it? Don’t say that “I don’t have time to take care of myself.” I’ve been there and done that. But I always promised myself that I was not going to be a martyr and sacrifice my health for my husband’s illness. Because if both of us were sick that wasn’t going to help anyone, least of all our children. They were barely adults when my husband was in the throes of Alzheimer’s disease. Our kids needed at least one healthy parent. And whether you are taking care of a spouse, parent or child, there are other people in your life who love and need you, not necessarily to take care of them, but to love and support them emotionally.

When you’re a caregiver, it’s hard to find the time to get the exercise you need or even take a shower, somedays. But it’s absolutely vital that you take care of yourself or you’ll end up getting sick and then who will take care of your loved one? Who will take care of YOU?

14 easy ways to take the edge off your stress and fatigue so you feel some relief.

  1. Say a positive affirmation before you get out of bed. “This day is going to be a good one.” “I am grateful for my friends and family.” “I am healthy and full of energy.” “I am strong and competent.” Say something positive to set the tone of the day.
  2. Before you reach for a cup of coffee, drink a glass of hot water with lemon. It hydrates your body and brain, the lemon helps to alkalize the system (yes, it’s counter intuitive), which is usually too acidic, and it helps with regularity.
  3. Ask for help! You don’t have to do it all by yourself. No one is going to think badly of you if you take some time for yourself. If your loved one resents your going out, it’s okay. Don’t become a slave to their wishes and rants. If you can’t leave your loved one alone, please ask a neighbor, friend or home care professional to help at least a couple hours a week. Some social service programs provide free respite care.
  4. Many cities throughout the U.S. offer volunteer snowbusters (volunteers who will shovel your walk and driveway), fix-it volunteers who will help with easy home repairs, and yard maintenance volunteers.
  5. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  6. Find a walking partner in your neighborhood and try to walk at least once a week (preferably 3 times a week).
  7. Put on a CD, vinyl record or the radio and listen to your favorite music. If your care partner is mobile, ask him/her to dance. There is nothing like music or dance to uplift the spirit.
  8. Find a virtual class online. Yoga, Pilates, Barre fitness, Zumba, Les Mills Bodypump and more are offered through the YMCA for free if you have Silver Sneakers. There are hundreds of other classes available online.
  9. Use essential oils to immediately diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit, lemon, orange, clary sage, geranium, rose, and ylang ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your collar or pillow. Find a fragrance that is pleasing to your care partner. It’ll help him/her also.
  10. Eat breakfast! It is the meal that you break your fast with. During the night our blood sugar levels drop, so it’s especially important to eat within one hour of arising and by 10am. Eating breakfast restores healthy blood sugar levels, but make sure your breakfast isn’t coffee and a doughnut. Have some protein and a healthy fat such as an omelet and avocado and a piece of whole grain or gluten-free toast. It’ll provide you with the energy you need to get through the morning while maintaining a sense of equilibrium.
  11. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  12. Include more fruits and veggies in your diet. Veggies are low in calories and high in fiber. Fruits are also high in fiber and like veggies, contain numerous vitamins and minerals. Just like people, fruits and vegetables come in a variety of shapes, sizes and colors. And it’s the colors that identify many of the bioactive substances called phytonutrients that give us antioxidant protection and other special health benefits.
  13. Avoid isolation. Staying connected, especially during the pandemic, is sooooo important! Join an online support group if you don’t have friends and family nearby to listen to your woes and help out. Here are two great ways to make meaningful connections online: https://wordpress.com/post/barbracohn.com/3517
  14. It’s important to get at least 6 hours (preferably 7 or 8) of sleep every night. Of course, this isn’t always possible if you are caring for someone and need to get up at night, or are worried about paying the bills, taking care of the car, getting a new stove, etc. If you can’t get in the hours at night, put your feet up for 10 minutes during the day when your care partner naps. Or take a power nap. It really helps.

Wishing you and your loved ones a healthy, happy New Year! And remember that “this too shall pass.”

image

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.